Int J School Health. 2016 October; 3(4):e34812.
doi: 10.17795/intjsh-34812.
Published online 2016 July 1.
Research Article
The Rational Emotive Behavioral Therapy and Students’ Defense
Mechanisms
Farideh Hamidi,1,* and Farshid Paidar1
1
Department of Educational Sciences, Shahid Rajaee Teacher Training University, Tehran, IR Iran
*
Corresponding author: Farideh Hamidi, Department of Educational Sciences, Shahid Rajaee Teacher Training University, Tehran, IR Iran. Tel: +98-2122970035, E-mail:
[email protected]
Received 2015 November 18; Revised 2016 January 17; Accepted 2016 January 20.
Abstract
Background: Defense mechanisms are psychological operations which often prevent stressful norms, beliefs, and values to emerge
and reach the level of consciousness.
Objectives: The aim of the present study was to investigate the effect of Rational Emotive Behavioral Therapy (REBT) on defense
mechanisms of boy high school students at east Azerbaijan, Iran.
Patients and Methods: This experimental study was conducted on all male students (n = 680) enrolled in the second and third
grades of high school in east Azerbaijan, Iran, during 2014 - 2015. To select the sample, first the defense style questionnaire (DSQ,
Andrews et al. 1993) was completed by 150 students and among those who had the required conditions to participate in the study, 30
students were randomly selected and divided into the control (n = 15) and experimental (n = 15) groups. Eight sessions of the REBT
were conducted on the experimental group. Data were analyzed using ANCOVA analysis with the SPSS software version 20.
Results: Results showed that after the interventions, a significant relationship was found between the control and experimental
groups in terms of using mature and immature defense mechanisms (P < 0.05). However, the relationship between the control and
experimental groups was not significant in terms of the neurotic defense mechanism (P > 0.05). In this regard, the rational emotive
behavioral group counseling leads to reduction of using immature defense mechanisms (F(1,2) = 43.55, P = 0, η p2 = 0.67) and increase
using of mature defense mechanisms (F(1,2) = 19.78, P = 0, η p2 = 0.42) among the students.
Conclusions: The results of the current study indicate that the REBT therapy can balance and improve defense mechanisms among
male high school students.
Keywords: Rational Emotive Behavioral Therapy, Defense Mechanisms, Students
1. Background
The concept of anxiety is a basic concept in the literature of mental problems. Anxiety is defined as a feeling of fear caused by the feelings, memories, desires, and
suppressed experiences that reach the level of consciousness. Anxiety can be considered as a state of tension that
arouses people to do something. Anxiety is created by the
conflict among Id, ego and superego in controlling the
mental energy. The duty of anxiety is to alert the eminent danger. Mechanisms are not understandable without
considering the anxiety that recalls them. Freud’s second
theory transferred the focus of exploration and therapy
from instinctual impulseto the “I”. I can realize anxiety and
then move forces for defending the eminent peril caused
by the accumulation of impulses. This theoretical revision by Freud puts more emphasis on the role of environment (noumenal and phenomenal environments). Hence,
I would have two functions, to inhibit action and move-
ment of emotions and impulses and to balance the environmental requirements (1). The history of employing defense in diagnosis of mental problems dates Freud’s works
(2), which were later corrected and published by his daughter Anna Freud in a series of seminal articles. Vaillant distinguished between defense styles in terms of their incidence at the stages of growth, i.e. rooted in different sexual
mental phases and pointed out that mature defenses lead
to healthier mental functioning (3). Andrews, Singh and
Bond identified twenty defense mechanisms and divided
them to three defense styles including mature, neurotic,
and immature (4). Mature defense mechanisms are identified as efficient, normal, and adaptive exposure methods
while, immature and neurotic defensive mechanisms are
considered as inefficient and not adaptive. Immature defense is observed among adolescents and some mentally
disordered patients. Neurotic defense is observed in hysteric and obsessive compulsive disorder (OCD) patients,
as well as adults under stress. Mature defense is seen in
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Hamidi F and Paidar F
healthy people (5). Defense mechanisms have three components: 1) an observable behavior (often a signal); 2) an
impulse or intention which is not acceptable for the patient and functions as a stressor causing emotional conflict and 3) The process that links the observed behavior
(or the signal) to the unacceptable intention or desire. The
relation between intention and desire to the observable
behavior or signal is only found through the interpretation of the therapist and the patient may reject or accept
it (6). According to Freud, defensiveness is unavoidable
even in the healthiest people. Also, in his view we have a
defensive state all the times. The conscious demands and
desires of Id must always remain hidden from the retribution eye of super-ego. Defensiveness cannot be eliminated even through specialized techniques such as psychoanalysis. At best, we can learn how to replace the defenses
that distort the reality in large scales with those defenses
that do this more delicately. Freud regards defense mechanisms very adaptive. In his view, these mechanisms are
little justified lies that give the person the possibility to
live by him/herself and the society. They enable individuals to cope with a mental threat without falling into the
surrealistic thinking or psychosis. Mature defenses allow
the biologic impulses to evolve in the constructive and useful ways (7). Many defense mechanisms basically emerge
in a specific order and during different phases of childhood growth. When an individual steps adulthood, regardless of the age that defense styles has originated, she
might employ several defenses altogether. In other words,
an adult may use the defense mechanisms of loquacity,
rational justification (emerged in the latent stage), identification with the mental image and/or the ideal object
(emerged in the adolescence stage) and projective blame
(emerged in the anal stage) (8). The attention to defense
mechanisms has been on increase in the recent years (9).
In the psychoanalysis system, every mental disorder is associated with certain nonadaptive defense mechanisms
and they play an important role in the mental health of
individuals (10, 11). Hence, the defense mechanisms logically have the capacity to be considered as one of the
main therapeutic factors and receive high attention in the
therapeutic interventions (12). Implicit and explicit findings emphasize the relationship between defense mechanisms and personality structure. In this regard, identification of defense mechanisms can open a way for recognition of individual differences and their personal structure. The attempt of defense mechanisms for removing
forbidden thoughts or at least reducing them leads to stabilization of certain features and characteristics (1). Millon
is among the scholars who had a revolutionary role in establishing the relationship between personality disorders
and defense mechanisms. He believes that a persistent re-
2
lationship exists among personality traits and the clinical spectrum of personality disorders with some defense
mechanisms. He associate esschizoid personality disorder
with intellectualization mechanism, avoidant personality
with fantasy mechanism, dependent personality with introjection mechanism, histrionic personality with dissociation mechanism, narcissist personality with rationalization mechanism, antisocial disorder involved with acting out, obsessive-compulsive personality disorder with
reaction formation, schizotypal personality disorder with
undoing mechanism, and borderline personality disorder
with repression (13). According to Maltby et al. (14) a number of positive personality traits such as the ability of forgiveness have a positive correlation with optimism, emotional intelligence, and self-respect and negative correlation with neurotic mechanisms. Hence, the presence of
this personality trait can be effective in improvement of
interpersonal relationship by employing mature mechanisms. In the recent studies, the relationship between defense mechanisms and different variables have been investigated including attachment styles (15), anger experience
and expression (16), written emotional expression, psychological welfare (17), job exhaustion of airline personnel (18),
psychological puberty (19), and psychological symptoms
of self-damaging (20). The rational emotive behavioral
therapy (REBT) assumes that human is born with either rational (direct) or irrational (twisted) thinking ability. People have the capacity of self-respect, enjoying thinking and
speaking, loving, communicating with others, growing,
and flourishing. They also have the capacity and preparation for self-destruction, avoiding thinking, procrastination, endless repetition of making mistakes, superstitions,
intolerance, perfectionism, self-blame, and repressing the
talents. The rational emotive behavioral therapy encourages people to accept who they are despite the mistakes
they might have (21). Ellis emphasizes that blaming causes
the majority of emotional agitations. If we want to remain mentally healthy, it is better to stop blaming ourselves and others and learn how to accept ourselves with
all faults in an unconditional way. Ellis stipulates that we
have a strong tendency to change our wishes and desires
to musts, should, orders and demands. When we are upset,
it is good to pay attention to despotic “musts”, “shoulds”,
and “ought to”. This kind of demands constitutes the basis of disordering emotions and unhealthy behaviors (22).
Cognitive restructuring is the main method of cognitive
therapy that teaches people how to improve them by replacing irrational beliefs with rational thoughts (23). In
restructuring, the patients are educated to monitor their
self-talk, identify self-incompatible talk, and replace it with
talking to their negative self (24). Vulnerability of individuals to sadness changes with regard to the biological, phys-
Int J School Health. 2016; 3(4):e34812.
Hamidi F and Paidar F
iological, and social factors. Human usually loves to enjoy
their privacy, social relations, sexual relations, work, and
recreation; however, their ineffective beliefs may not allow
them. Ellis counts twelve irrational beliefs that upset individuals and prevents them from achieving their goals (25).
Due to the importance of this approach for the beliefs system of people, many studies have investigated its efficiency
for helping different groups of the society, such as investigating the effect of the REBT group therapy on reducing the
anxiety among girl high school students (26), the effect of
REBT on stress coping strategies and self-efficacy (27), the
effect of combining REBT and art therapy on improvement
of self-confidence and flexibility (28), and the effect of educational emotional model on the illogical beliefs and stress
among the students (29). Regarding the importance of defense mechanisms in emergence of problems and the effectiveness of REBT, in this study we tried to answer the question that whether REBT has any effect on the defense mechanisms of boy students?
3.1. Instruments
Defense style questionnaire (DSQ-40) is constructed
based on the defense hierarchy model. It was first developed in 1983 by Andrews et al. (4, 31) to investigate the defense mechanisms among normal and abnormal individuals. It consisted of 88 items that explored 24 mechanisms.
This questionnaire was reviewed several times and its latest version was developed by Andrews et al. (4, 32) in 1993,
including 40 questions that explore 20 defensive mechanisms at three levels of mature, neurotic, and immature.
The items of this questionnaire are responded based on
a 9 degree scale from completely disagree to completely
agree, and the respondent must choose her level of agreement with the statements on defense mechanisms (33). Besharat et al. (33). reported the Cronbach’s alpha coefficient
for mature, immature, and neurotic styles as 0.75, 0.73, and
0.74, respectively and the retest validity coefficient with
the interval of 4 weeks as 0.82. Accordingly, DSQ-40 was
proved to have a good validity in the studied population.
3.2. Administration
2. Objectives
The aim of the present study was to examine the effect
of REBT on defense mechanisms of male high school students at east Azerbaijan.
3. Patients and Methods
The present study was an empirical study using pretest
and posttest with a control group. In this study, the participants were selected by simple random sampling and assigned to two separate groups, control and experimental.
Both groups received the posttest; then the independent
variable was conducted on the experimental group and at
the end, both groups were evaluated. The statistical population of study included all 2rd and 3rd grade male high
school students of east Azerbaijan who enrolled in 2014 2015 academic year. The number of boys’ high schools in
the town was 4, including 680 2rd and 3rd grade students
in total. The size of sample in this study due to its experimental was 30 students (30). First, a clustered random selection was done, choosing one school among the 4, then
150 questionnaires were distributed among 2rd and 3rd
grade students of this school. Those who scored one standard deviation higher than the mean score in a defense
style questionnaire included 45 students among which 30
were selected as the sample by the simple random sampling method and then the participants were randomly divided into experimental and control groups.
Int J School Health. 2016; 3(4):e34812.
The content of counseling sessions is presented in the
following. The first session started with introduction of
members, warm-up, and the rules and objectives of the
group were determined; and the subject of how to distinguish between suitable and unsuitable feelings was discussed with the adolescents. In the second session, to learn
the main principles of the scientific method of thinking
about ourselves, others, and life a group discussion and
counseling with members were run. In the third session,
the Ellis A-B-C model was taught. In the 4th session, the focus was on how to distinguish between wishes and musts,
identifying Ellis three basic musts and challenging them.
In the 5th session, the focus was on the subject of how to
solve our real problems along with our emotional problems, as well as changing the thoughts or actions against
them. In the 6th session, the four pairs of beliefs were explored: 1) preferences vs. musts, 2) anti-awfulising vs. awfulising 3) high frustration tolerance vs. low frustration
tolerance 4) acceptance of self or other or the world vs. self,
other, or world damning. In the 7th session, the description of defensive mechanisms and styles, and their persistent effect on anxiety and irrational beliefs were presented
in terms of REBT of Ellis. In 8th session, the ability of promoting the tolerance capacity was discussed with members and a final review on the contents and materials provided so far was done.
3.3. Data Analysis Method
To examine research dependent variables, descriptive
statistics such as mean and standard deviation was used.
3
Hamidi F and Paidar F
Also, for testing the research hypotheses inferential statistics including covariance analysis and the Levin’s variance
homogeneity test was run. The level of significance was
considered 0.05.
4. Results
In this part, mean and standard deviation of defensive
mechanisms in the pretest and posttest are presented (Table 1).
Table 1. Descriptive Indexes of Subcategories of Defensive Mechanismsa
Variable
Control
Experimental
Pre-test
44.27 ± 9.84
49.07 ± 9.23
Post-test
44.47 ± 9.54
57.07 ± 5.13
Pre-test
148.60 ± 8.31
153.07 ± 15.38
Post-test
148.13 ± 8.45
116.13 ± 18.51
Pre-test
47.00 ± 11.40
47.67 ± 9.75
Post-test
47.13 ± 11.23
45.47 ± 7.64
Mature
Table 2, the calculated F in the mean score of mature and
immature categories between the control and experimental groups (with pretest control) was significant at the error level of 5 percent. Hence, the null hypothesis was rejected and at the confidence level of 95%, a significant difference was found in mean scores of mature and immature
mechanisms of the control and experimental groups. Also,
the group rational emotive behavioral counseling was effective in reducing the use of immature defense mechanisms (F(1,2) = 43.55, P = 0, η p2 = 0.67) and increasing the use
of mature defenses (F(1,2) = 19.78, P = 0, η p2 = 0.42) among
high school students. However, the calculated F in the neurotic mean scores of the experimental and control groups
(with pretest control) was not significant at the error level
of 5% hence the null hypothesis was accepted. Thus, results
showed that REBT had no effect on reducing the use of neurotic defenses among high school students (F(1,2) = 0.46, P=
0.499, η p2 = 0.017).
Immature
Neurotic
a
Values are expressed as mean ± SD.
As shown in Table 1, there is a difference in the scale
of defense mechanism in the mean scores of pretest and
posttest of the two groups. It is also observed that in
the experimental group, the mean scores are reduced in
the posttests of neurotic and immature variables while increased in the mature variable. For testing the variance
equality, data were examined with the Levin’s homogeneity test. Results showed that the variance of control and
experimental groups are homogenous in the subscales of
mature (F = 0.776, P = 0.082), immature (F = 1.810, P = 0.189)
and neurotic (F = 1.959, P = 0.173). Also, the multivariate covariance analysis tests including Pillai’strace, Wilk’s
Lambda, hoteling trace, etc. were done. Also, the value of
Wilk’s Lambda was estimated (0.350) and F (1.856) with degrees of freedom 3 and 26 which showed significant homogeneity and indicated that the control and experimental
groups had a significant difference in terms of at least two
dependent variables. As a result, covariance analysis was
used for data analysis. The result of covariance analysis on
the general adaptability variable and its subcategories in
control and experimental groups are presented in Table 2.
To investigate the mean scores of defensive mechanisms in the control and experimental groups (with
pretest control), ANCOVA analysis was used. As shown in
4
5. Discussion
According to the results of the current study, the REBT
can lead to reducing the use of immature defense mechanisms and also increasing the use of mature ones among
the participants of the experimental group compared to
those at the control group in the pretest. In a study by
Javaheri et al. (16) the relationship between defense mechanisms and the experience and expression of anger was
investigated among 213 girl students educating at undergraduate courses of Shahid Beheshti university. The results showed that mature defenses have a positive correlation with the experience and control of anger, while showing a negative correlation with anger expression and its
subscales such as verbal and physical emergence of anger,
angry mood and reactions. Also, immature and neurotic
mechanisms had a negative correlation with the experience and control of anger, and a positive correlation with
anger expression and its subscales. In fact, those who use
mature defenses can experience feelings such as anger and
thus are able to control their anger more effectively. However, those who use immature and neurotic defense mechanisms avoid experiencing their feelings which does not
mean eliminating it, but the feeling is being suppressed
and projects through behaviors which are sometimes out
of control. As a result, people should be educated to use
mature defense mechanisms. Moreover, defense mechanisms have been investigated in relation to different behaviors such as depression, anxiety, normal people, educational advance, etc. by different researchers during recent years (6, 17, 19, 20, 34, 35). In relation to the research
variables, the results of covariance analysis of experimental and control groups determined that all variables exInt J School Health. 2016; 3(4):e34812.
Hamidi F and Paidar F
Table 2. Test of Traces to Find the Difference Between Scores of Defense Mechanisms in the Control and Experimental Groups
Source of Changes
SS
df
MS
F
P
Eta2
Mature
727.008
1
727.008
19.778
0
0.423
Immature
8265.957
1
8265.957
43.551
0
0.617
26.019
1
26.019
0.469
0.499
0.017
Neurotic
cept the neurotic defense mechanism are statistically significant. According to McAdams (36), the neurotic defense
mechanisms are incompatible ways to encounter the anxiety due to the hidden and suppressed desires; it can be
said that it is more profound and complicated compared
to other variables and requires more attention and investigation. Hence, the short term of this therapy can be one
of the reasons that caused it to be insignificant. In the
view of Blackman (8) humans use these defenses to remove
their undesired feelings and thoughts from the conscious
realm; and use a range of harmless jokes to attacking their
beloved ones to avoid the painful memories of the past;
these defenses help us to cover their sadness or transfer it
to others. In explaining the findings of this study, it can
be said that since both variables of these hypothesis i.e.
the REBT and defense mechanisms involve the beliefs and
opinion of people, the existence of a relationship between
the two variables is logical theoretically and REBT can be
helpful in determining the amount of using defense mechanisms. When faced with anxiety caused by various educational situations, adolescents resort to a series of defense
mechanisms that can be balanced in a number of ways, including therapies, how to avoid becoming upset, and increasing the tolerance to failures and challenging the irrational thoughts and beliefs and musts that are inducted to
us by the environment or built by our minds, in total finding a philosophy of life. This study was done on the boy students and regarding gender differences, it is not generalizable to girl students. Due to the lack of access to the list of
all members of the population, cluster sampling method
was used. It is suggested that REBT is taught to the educational counselors and mentors with an applied purpose so
that by implementing this training the irrational thoughts
of high school students which are the cause of their anxiety, and the subsequent immature and neurotic defense
mechanisms are treated and cured.
Acknowledgments
We greatly appreciate all students and directors of
schools who cooperated with us in this research.
Int J School Health. 2016; 3(4):e34812.
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